Retrospect of Influenzas and Epidemic Agues in the 16th and 17th centuries.
In the former volume of this history I have dealt with the various epidemics of “hot ague,” “new disease” or the like down to the epidemic of 1657-59. It will be convenient to go over some of that ground again, with a view to distinguish, if possible, the catarrhal types from the aguish, and to illustrate the use of the word ague as applied to a universal epidemic. Two of the epidemic seasons in the 16th century, 1510 and 1539, are too vaguely recorded for our purpose; but I shall review briefly the seasons from 1557-58 onwards.
It is known from the general historians that there were two seasons of fever all over England in 1557 and 1558, of which the latter was the more deadly, the type according to Stow, being “quartan agues.” In letters of the time the epidemic of 1557 is variously named: thus Margaret, Countess of Bedford, writes on 9 August from London to Sir W. Cecil that she “trusts the sickness that reigns here will not come to the camp [near St Quentin, where Francis, Earl of Bedford was].... As for the ague, I fear not my son.” On the 18th of the same month, Sir Nicholas Bacon writes from Bedford to Cecil: “Your god-daughter, thanks be to God, is somewhat amended, her fits being more easy, but not delivered of any. It is a double tertian that holds her, and her nurse had a single, but it is gone clearly;” to which letter Lady Bacon adds a postscript about “little Nan, trusting for all this shrewd fever, to see her.” On 21 September, it appears that the sickness had reached the English camp near St Quentin, for the Earl of Bedford writes: “Our general is sick of an ague, our pay very slack, and people grudge for want.” As late as the 25th October the Countess of Bedford writes from London to Cecil that she “would not have him come yet without great occasions, as there reigns such sickness at London[540].”
Next year, 1558, the epidemic sickness returned in the summer and autumn, in a worse form than before. Stow calls it “quartan agues,” which destroyed many old people and especially priests, so that a great number of parishes were unserved. Harrison, a canon of Windsor, says that a third part of the people did taste the general sickness. On the 6th September, sickness affected more than half the people in Southampton, Portsmouth, and the Isle of Wight. From the 20th October to the end of the year, no fewer than seven of the London aldermen died, a number hardly equalled in the first sweating sickness of 1485, and the queen (Mary) died of the lingering effects of an ague, which was doubtless the reigning sickness. On 17th October, the English commissioners being at Dunkirk to negotiate the surrender of Calais, one of them, Sir William Pickering, fell “very sore sick of this new burning ague: he has had four sore fits, and is brought very low, and in danger of his life if they continue as they have done.” That year Dr Owen published A Meet Diet for the New Ague, and himself died of it in London on the 18th of October[541].
Fuller quaintly describes the ague of 1558 as “a dainty-mouthed disease, which, passing by poor people, fed generally on principal persons of greatest wealth and estate[542].” Roger Ascham wrote in 1562 to John Sturmius that, for four years past, or since 1558, “he was afflicted with continual agues, that no sooner had one left him but another presently followed; and that the state of his health was so impaired and broke by them that an hectic fever seized his whole body; and the physicians promised him some ease, but no solid remedy[543].” Thoresby, the Leeds antiquary of the end of the 17th century, found in the register of the parish of Rodwell, next to Leeds, a remarkable proof of the fatality of these agues, which fully bears out the general statements of Stow and Harrison. In 1557 the deaths in the register rose from 20 to 76, and in 1558, which the historians elsewhere say was the most fatal year, they rose to 124[544]. This was as severe as the sweating sickness of 1551, for example in the adjoining parish of Swillington, or in the parish of Ulverston, in Lancashire[545].
The English names of the epidemic sickness in the summers and autumns of 1557 and 1558 are all in the class of agues—“this new burning ague,” “a strange fever,” “divers strange and new sicknesses taking men and women in their heads, as strange agues and fevers,” “quartan agues.” One medical writer, Dr John Jones, says in a certain place that “quartans were reigning everywhere,” and in another place, still referring to 1558, that he himself had the sickness near Southampton, that it was attended by a great sweat, and that it was the same disease as the sweating sickness of 1551. There were certainly two seasons of these agues, 1557 and 1558, the latter being the worst; and it is probable from Short’s abstracts of a few parish registers in town and country that there was a third season of them in 1559. The year 1557 has been made an influenza year, perhaps because the Italian writers have emphasized catarrhal symptoms here or there in the epidemic of that year; while both the years 1557 and 1558 have been received into the chronology of epidemic or pandemic agues or malarial fevers[546]. There are perhaps a dozen English references in letters and chronicles to the sicknesses of those years, either to particular cases or to a general prevalence, but they do not enable us to distinguish a catarrhal type in 1557 from the aguish type which they assert for both 1557 and 1558.
Four years after, another very characteristic influenza was prevalent in Edinburgh.
Randolph writes from Edinburgh to Cecil in the end of November, 1562: “Maye it please your Honer, immediately upon the Quene’s (Mary’s) arivall here, she fell acquainted with a new disease that is common in this towne, called here the newe acqayntance, which passed also throughe her whole courte, neither sparinge lordes, ladies nor damoysells, not so much as ether Frenche or English. It ys a plague in their heades that have yt, and a sorenes in their stomackes, with a great coughe, that remayneth with some longer, with others shorter tyme, as yt findeth apte bodies for the nature of the disease. The queen kept her bed six days. There was no appearance of danger, nor manie that die of the disease, excepte some olde folkes. My lord of Murraye is now presently in it, the lord of Lidingeton hathe had it, and I am ashamed to say that I have byne free of it, seinge it seketh acquayntance at all men’s handes[547].”
It is not improbable that the interval between 1558 and 1562 may have been occupied with milder revivals of the original great epidemic, the one at Edinburgh counting in the series.
It appears from a Brabant almanack for the year 1561 that a sudden catarrhal epidemic was quite on the cards in those years: the astronomer foretells for the month of September, 1561: “Coughs innumerable, which shall show such power of contagion as to leave few persons unaffected, especially towards the end of the month[548].” There is an actual record from more than one country (Italy, Barcelona, as well as Edinburgh) of such universal catarrhs and coughs a year later than the one foretold. The Italian writers assign the universal catarrhs and coughs to the autumn of 1562, the Barcelona writer to the winter solstice of that year, and the letter from Edinburgh to “the laste of November.”
The next undoubted influenza, that of 1580, was compared abroad to the English sweat:
“In some places,” says Boekel, “the sick fell into sweats, flowing more copiously in some than in others, so that a suspicion arose in the minds of some physicians of that English sweat which laid waste the human race so horribly in 1529;” and again, “the bodies were wonderfully attenuated in a short time as if by a malignant sudden colliquation, which made an end of the more solid parts, and took away all strength[549].” The season of it was the summer.
The outbreak attracted much attention from its universality, and was described by many abroad.
Boekel says that it was of such fierceness “that in the space of six weeks it afflicted almost all the nations of Europe, of whom hardly the twentieth person was free of the disease, and anyone who was so became an object of wonder to others in the place.... Its sudden ending after a month, as if it had been prohibited, was as marvellous as its sudden onset.” It came up, he says, from Hungary and Pannonia and extended to Britain. The principal English account of this epidemic comes from Ireland[550]. In the month of August, 1580, during the war against the Desmonds, an English force had advanced some way through Kerry for the seizing of Tralee and Dingle; “but suddenlie such a sicknes came among the soldiers, which tooke them in the head, that at one instant there were above three hundred of them sicke. And for three daies they laie as dead stockes, looking still when they should die; but yet such was the good will of God that few died; for they all recovered. This sicknesse not long after came into England and was called the gentle correction.”
This outbreak among the troops in Ireland is said to have been in August, before the sickness came to England. But it can be shown to have been at its height in London in the month of July. The year 1580 was almost free from plague in London; the weekly deaths are at a uniform low level (a good deal below the births) from January to December, except for the abrupt rise shown in the following table,—the kind of rise which we shall see from many other instances to be the infallible criterion of an influenza[551]:
Weekly Deaths in London.
1580.
| Week ending | Deaths by all causes | Dead of plague | Baptised | ||||
| June | 23 | 55 | 2 | 59 | |||
| " | 30 | 47 | 4 | 57 | |||
| July | 7 | 77 | 4 | 65 | |||
| " | 14 | 133 | 4 | 66 | |||
| " | 21 | 146 | 3 | 61 | |||
| " | 28 | 96 | 5 | 64 | |||
| Aug. | 4 | 78 | 5 | 73 | |||
| " | 11 | 51 | 4 | 53 | |||
| " | 18 | 49 | 1 | 72 | |||
As in 1557-58, the English references are to agues, both before and after the Gentle Correction of July-August, 1580. Cogan says that for a year or two after the Oxford gaol fever (1577) “the same kind of ague raged in a manner all over England and took away many of the strongest sort in their lustiest age, etc.” And he seems to have the name “gentle correction” in mind when he says: “This kind of sickness is one of those rods, and the most common rod, wherewith it pleaseth God to brake his people for sin.” Cogan’s dates are indefinite. But there is a letter of the Earl of Arundel to Lord Burghley, 19th October, 1582, which shows that “hot ague” was epidemic as late as the second autumn after the influenza proper: “The air of my house in Sussex is so corrupt, even at this time of the year, as when I came away I left twenty-four sick of hot agues.”
Two such epidemics in England as those of 1557-8 and 1580-82, of hot agues or strange fevers, taking the forms of simple tertian or double tertian or quartan or other of the classical types, would have made ague a familiar disease, and its name a household word. For not only were there two or more aguish seasons (usually the summer and autumn) in succession, but to judge by later experience there would have been desultory cases in the years following, and in many of the seizures acquired during the height of the epidemic, relapses or recurrences would have happened from time to time or lingering effects would have remained. Hence it is unnecessary to assume that the agues that we hear casual mention of had been acquired by residence in a malarious locality. They may have been, and most probably were, the agues of some epidemic prevalent in all parts of the country. These epidemics were the great opportunities of the ague-curers, as we shall see more fully in the sequel. It is to the bargaining of such an empiric with a patient that Clowes refers in 1579: “He did compound for fifteen pound to rid him within three fits of his ague, and to make him as whole as a fish of all diseases.”
There were more sicknesses of that kind, perhaps not without a sweating character, in the last ten years of the 16th century[552]. But they are indefinitely given as compared with earlier and later epidemics, and I shall pass to the next authentic instance.
The autumn of 1612 was undoubtedly a season of epidemic ague or “new disease” in England[553]. When Prince Henry, eldest son of James I., fell ill in November, in London, during the gaieties attending the betrothal of his sister the Princess Elizabeth to the Count Palatine of the Rhine, a letter-writer of the time said of his illness: “It is verily thought that the disease was no other than the ordinary ague that hath reigned and raged almost all over England since the latter end of summer[554].” The attack began in the end of October. The spirited and popular prince had been leading the gaieties in place of his father, who could not stand the fatigue, and was “seized by a fever that came upon him at first with a looseness, but hath continued a quotidian ever since Wednesday last [before the 4th of November], and with more violence than it began, so that on Saturday he was let blood by advice of most physicians, though Butler, of Cambridge, was loth to consent. The blood proved foul: and that afternoon he grew very sick.... I cannot learn that he had either speech or perfect memory after Wednesday night, but lay, as it were, drawing on till Friday between eight and nine of the evening that he departed. The greatest fault is laid on Turquet, who was so forward to give him a purge the day after he sickened, and so dispersed the disease, as Butler says, into all parts; whereas if he had tarried till three or four fits had been passed, they might the better have judged of the nature of it; or if, instead of purging, he had let him blood before it was so much corrupted, there had been more probability.” At the dissection, the spleen was found “very black, the head full of clear water and all the veins of the head full of clotted blood. Butler had the advantage, who maintained that his head would be found full of water, and Turquet that his brains would be found overflown and as it were drowned in blood[555].” Butler, it appears, was “a drunken sot.” When King James asked him what he thought of the prince’s case, he replied “in his dudgeon manner” with a tag of verse from Virgil ending with “et plurima mortis imago.” The Princess Elizabeth could not be admitted to see her brother “because his disease was doubted to be contagious[556].” It was at least epidemic, for in the same week alderman Sir Harry Row and Sir George Carey, master of the wards, died “of this new disease[557].” The earliest reference to it that I find is the death, previous to 11 September, of Sir Michael Hicks at his house Rackholt in Essex, “of a burning ague,” which came, as was thought, by his often going into the water this last summer, he being a man of years[558]; but much more probably was a case of “the ordinary ague that hath reigned and raged almost all over England since the latter end of summer.” The next year was still more unhealthy, to judge by samples of parish registers; agues are mentioned also in letters; thus, one going on 25 March, 1613, to visit Sir Henry Savile, found him “in a fit, an ague having caught hold of him[559].”
The winter of 1613-14 was marked by most disastrous floods in Romney Marsh, in Lincolnshire, in the Isle of Ely, and about Wisbech, and most of all in Norfolk[560]; but the malarious conditions so brought about, being subsequent to, were not conceivably the cause of, the epidemics of ague in the autumn of 1612 and 1613, which made so great an excess of burials over christenings in the parish registers.
A curious record remains of an aguish sickness in a child, which had begun about January, 1614. On 18 March, of that year, the dowager Countess of Arundel wrote from Sutton, near Guildford, to her son Earl Thomas, who was making the grand tour to Rome and elsewhere with his wife, and had left the children to the care of their grandmother: “Your two elder boys be very well and merry, but my swett Willm. continueth his tersion agu still. This day we expect his twelfth fitt. I assur myselfe teeth be the chefe cause. I look for so spedy ending of it, he is so well and merry on his good days, and so strong as I never saw old nor yonge bear it so well. I thank Jesu he hath not any touch of the infirmity of the head, but onely his choler and flushe apareth, but he is as lively as can be but in the time of his fits onely, which continueth some eight hours[561].”
The epidemic of ague or “new disease,” which began to rage all over England in the end of the summer, 1612, had probably recurred in the years following, down to 1616. There is not a trace of plague during those years in any known record; and yet they are among the most unhealthy years in Short’s abstracts of town and country parish registers[562].
The first half of the 17th century is a period which is almost a blank in the conventional annals of “influenza” in Europe. But that period, which was the period of the Thirty Years’ War, had many widespread sicknesses. I do not wish to claim these as influenzas, or to contend that they were infections equivalent thereto in diffusiveness. We may, however, find a place for them in this context; for they were certainly as mysterious as any epidemics admitted into the canon of influenzas. So far as concerns Britain, the first was the epidemic ague, or “new disease,” of 1612 and 1613, probably recurring until 1616. The second was the universal spotted fever of 1623 and 1624, of which I have given an account in the chapter on typhus. That was followed by the plague of 1625, and that again by a harvest ague in the country in the end of the same year. The next epidemic ague or “general sickness, called the new disease,” fell mostly in England upon the two years 1638 and 1639. It was in part a harvest ague, “a malignant fever raging so fiercely about harvest that there appeared scarce hands enough to take in the corn[563]”; but it was also a winter disease. I pass over the war-typhus of 1643, to which the name of “new disease” was also given, and the widespread fever of the year following. In 1651 we hear again of a strange ague, which “first broke out by the seaside in Cheshire, Lancashire and North Wales,” eighty or a hundred being sick of it at once in small villages. Whitmore, who saw this epidemic in Cheshire, identified it with the Protean disease which he described in 1657-58, and hazarded the theory that the former was a diluted or “more remiss” infection carried by the wind from Ireland, where the plague was then raging, in Dublin, Galway, Limerick and other places, after their sieges or occupations by the army of the Commonwealth.
Thus in the first half of the 17th century we have more or less full evidence of epidemics of “new disease” in 1612-13, 1623-24, 1625, 1638-9, 1643-4 and 1651, not one of which was an influenza as we understand the term[564].
We come at length to the years 1657-59, in the course of which one catarrhal epidemic, or perhaps two, did prevail for a few weeks. The hot agues or “new disease” had been raging all over the country from the summer of 1657; then in April, 1658, there came suddenly universal coughs and catarrhs, “as if a blast from the stars”; they ceased, and the hot agues dragged on through the summer and autumn. A letter from London, 26 October, 1658, says: “A world of sickness in all countries round about London: London is now held to be the wholesomest place,” and adds that “there is a great death of coach-horses almost in every place, and it is come into our fields[565].” It was after this, in the spring of 1659, if Whitmore has made no mistake in his dates, that coughs and catarrhs “universally infested London, scarce leaving a family where any store were, without some being ill of this distemper.” The details have been given fully in the former volume[566]. I wish merely to remark here that the two catarrhal epidemics, or influenzas proper, in two successive springs, were sharply defined episodes in the midst of a period of epidemic agues, and that the “new disease” as a whole, during the two or three years that it lasted, had such an effect in the way of ill health and mortality that it was afterwards viewed as a “little plague” worthy of being set in comparison with the Great Plague of 1665.
Willis does not say that the epidemic agues lasted after 1658, perhaps because his essay was printed early in 1659; but Whitmore, whose preface is dated November, 1659, says, without distinguishing the hot ague from the catarrhal fever but speaking of them both as one Protean malady: “it now begins again, seizing on all sorts of people of different nature, which shows that it is epidemic.” Sydenham does not appear upon the scene until 1661; but when his epidemic constitutions do begin, it is with intermittents or agues, which lasted, according to him, until 1664. Perhaps if Sydenham’s experience had extended back to 1657 he would have made his aguish constitution to begin with that year, and to go on continuously until 1664. At all events it does not appear that the year 1660 was a clear interval between Willis’s and Whitmore’s period of 1657-59, Sydenham’s period of 1661-64; for it so happens that John Evelyn has left the following note of his own illness:
“From 17 February to 5 April [1660] I was detained in bed with a kind of double tertian, the cruell effects of the spleene and other distempers, in that extremity that my physicians, Drs Wetherburn, Needham and Claude were in great doubts of my recovery.” Towards the decline of his sickness he had a relapse, but on the 14th April “I was able to go into the country, which I did to my sweete and native aire at Wooton.” On the 9th of May he was still so weak as to be unable to accompany Lord Berkeley to Breda with the address inviting Charles II. to assume the crown.
Sydenham makes the “constitution” which began for him in 1661 to decline gradually, and to end definitely in 1664, after which he finds intermittents wholly absent for thirteen years, or until 1677. This clear interval will make a convenient break in the chronology, whereat we may bring in the popular and professional notions of ague then current, and the popular practice in that disease by empirics.